Healthcare Provider Details

I. General information

NPI: 1457119588
Provider Name (Legal Business Name): CELESTE WOOTEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 WELLTOWN LN
MURFREESBORO TN
37128-5106
US

IV. Provider business mailing address

2157 WELLTOWN LN
MURFREESBORO TN
37128-5106
US

V. Phone/Fax

Practice location:
  • Phone: 270-938-3033
  • Fax:
Mailing address:
  • Phone: 270-938-3033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0000256905
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number40453
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: